微创清除治疗颅内血肿60例临床分析

目的分析应用微创清除术治疗颅内血肿的临床效果,探讨其临床适用性。方法选择2008年10月至2013年5月于张家口市第一医院就诊的颅内血肿患者123例,采用随机数字表法分为微创清除术组60例和保守治疗组63例,保守治疗组给予保守内科治疗方式,微创清除术组在内科保守治疗的基础上采用微创清除术治疗。观察两组患者的血肿清除情况,神经功能改善情况及临床疗效和预后。结果两组患者经过治疗后,血肿部分清除,其中微创清除术组患者的血肿清除65%以上,所占比率显著高于保守治疗组,差异有统计学意义(P<0.05),经过4周治疗后,两组患者神经功能缺损评分均有所好转(P<0.05),微创清除术组患者在治疗后的神经功能缺损评分,优于保守治疗组(13.6±7.7)vs(19.9±7.6)]分(P<0.01)。两组患者治疗后症状均有所缓解,按照疗效标准,微创清除术组患者的治疗有效率为83.33%(50/60),也优于保守治疗组的61.90%(39/63)(P<0.01);两组患者治疗4周后,微创清除术组患者的预后有效率为86.67%,高于保守治疗组患者的71.43%,差异有统计学意义(P<0.05)。结论微创清除术治疗颅内血肿临床疗效稳定,对于颅内的适度出血有很好的疗效,可以在有CT设备的基层医院长期推广应用。

Clinical Analysis of Minimally Invasive Treatment of Intracranial Hematoma in 60 Cases

Objective To analyze the clinical results of minimally invasive surgery for intracranial hematoma, to explore its clinical applicability. Methods A total of 123 cases of intracranial hematoma were selected from Zhangiiakou First Hospital during Oct. 2008 and May 2013 ,and were divided into the minimally invasive surgery group of 60 patients and conservative treatment group of 63 cases according to random-number table method. The conservative treatment group was give conservative internal medical treatment, while the minimally invasive surgery group was also given the minimally invasive removal surgery on the. basis of conservative treatmetn. The hematoma in patients, neurelogical function improvement and clinical efficaey and prognosis of the two groups were observed. Results After treatment, hematoma was partially cleared, the pro- portion of over 65% hematoma clearance of the minimally invasive surgery group was significantly higher than the conservative treatment group（ P 〈0.05 ） ,the neurological defect scores of the two groups were improved （ P 〈 0.05 ）, and the improvement in the minimally invasive surgery group was better than the conservative treatment group （ 13.6 ± 7.7 ） vs （ 19.9 ± 7.6 ） ], the difference was statistically significant （ P 〈 0.05 ）. After treatment, the symptoms in both groups were relieved, according to the therapeutic standard, the effective rate of the minimally invasive surgery group was 83.33% （50/60） ,which was better than the 61.90% （39/63） of the conservative treatment group（ P 〈 0.01 ） ; the prognosis effective rate of the minimally inva- sire treatment group was 86.67% ,higher than the 71.43% of the conservative treatment group with statistically significant difference （ P 〈 0.05 ）. Conclusion Minimally invasive surgery for intracranial moderately bleeding has good effect, and can be used in basic hospital where CT device is available.